246 Bethesda Ln (3)DAVIE COUNTY HEALTH DEPARTMENT
(Septic Tank) . Improvements Permit and Certificate of Completion
(Ground Absorption Sewage Di_sposal,System - G.S. Chapter 130 -Article 13C)'
OWNER'OR CANTRACTOR C., X V t�, 7 0 ` f A F � +�t DATE ,S' ~`�=' 1- � *�-PERM*ITT
LOCATION _ ' u 1\ 154
S.R. NO. c,?s -
SUBDIVISION NAME LOT NO. SECTION OR BLOCK NO.
HOUSE ❑ MOBILE HOME I"` BUSINESS ❑
NO. BEDROOMS F. NO. BATHROOMS
GARBAGE DISPOSAL UNIT YES ❑ NO
AUTO. DISHWASHER YES ❑ , NO Q'
AUTO. WASH. MACHINE YES Mr NO ❑
SITE SUITABLE YES ❑ NO ❑
SIZE OF TANK fila gal.
NITRIFICATION FIELD 6 u sq. ft.
DEPTH OF STONE IN LINES:' A°moi" f'-;.. �i•=
WATER SUPPLY: IndividualPublic ❑
IMPROVEMENTS PERMIT BY
�a
House Trailer
Two Bedroom House
Three Bedroom House
Four Bedroom House
3ydRQ(0&14 S.%, 1 svt�l�jNec"
INSTALLED BY
CERTIFICATE OF COMPLETION By '1 Date
(8/16/73) *Construction mu tkajAy C'1 applicable State and locyl—t1pso alons
LOT AREA /
"D -9-q, . F t.
+� 00 Ga(=600S'.—
Ft
900 Gal.
900 Sq. Ft.
1000 Gal.
1200 Sq. Ft.
3ydRQ(0&14 S.%, 1 svt�l�jNec"
INSTALLED BY
CERTIFICATE OF COMPLETION By '1 Date
(8/16/73) *Construction mu tkajAy C'1 applicable State and locyl—t1pso alons
LOT AREA /
6 1- !
s.
6 1- !